{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:13:27Z","timestamp":1789179207287,"version":"build-2803163510"},"reference-count":74,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,2,9]],"date-time":"2016-02-09T00:00:00Z","timestamp":1454976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["103\u20102314\u2010B\u2010002\u2010086"],"award-info":[{"award-number":["103\u20102314\u2010B\u2010002\u2010086"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Use of polysomnography (\n                      <jats:styled-content style=\"fixed-case\">PSG<\/jats:styled-content>\n                      ) is the gold standard of diagnosis and measurement of treatment effectiveness for paediatric obstructive sleep apnoea (\n                      <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                      ). Although adenotonsillectomy (T&amp;A) is effective in diminishing the apnoea\u2013hypopnoea index (\n                      <jats:styled-content style=\"fixed-case\">AHI<\/jats:styled-content>\n                      ), a meta\u2010analysis of postoperative changes for all other\n                      <jats:styled-content style=\"fixed-case\">PSG<\/jats:styled-content>\n                      parameters and outcome comparisons between obese and non\u2010obese children following T&amp;A have never been conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective of review<\/jats:title>\n                    <jats:p>\n                      To comprehensively review polysomnographic findings after surgery for obese and non\u2010obese children with\n                      <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search strategy<\/jats:title>\n                    <jats:p>\n                      Study protocol was registered on\n                      <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content>\n                      (\n                      <jats:styled-content style=\"fixed-case\">CRD<\/jats:styled-content>\n                      42013004737). Two authors independently searched databases including PubMed,\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      ,\n                      <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                      and Cochrane Review from January 1997 to July 2014. The keywords used included the following: sleep apnea,\n                      <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                      , sleep apnea syndromes, tonsillectomy, adenoidectomy, infant, child, adolescent, and Humans.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evaluation method<\/jats:title>\n                    <jats:p>\n                      A comprehensive systematic review and meta\u2010analysis for literature for\n                      <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                      children treated by T&amp;A with polysomnography data. Random\u2010effects model was applied to determine postoperative sleep parameter changes and the surgical success rate between obese and non\u2010obese groups. The quality of studies was assessed using the Newcastle\u2013Ottawa Scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 51 studies with 3413 subjects were enrolled. After surgery, sleep architecture was altered by a significant decrease in sleep stage 1, and an increase in slow\u2010wave sleep and the rapid eye movement stage, and enhanced sleep efficiency. The mean difference between pre\u2010 and postoperative was a significant reduction of 12.4 event\/h in\n                      <jats:styled-content style=\"fixed-case\">AHI<\/jats:styled-content>\n                      , along with a reduction of obstructive index, hypopnoea index, central index and arousal index. Mean and minimum oxygen saturation increased significantly after surgery. The overall success rate was 51% for postoperative\n                      <jats:styled-content style=\"fixed-case\">AHI<\/jats:styled-content>\n                      &lt;1 (obese\n                      <jats:italic>versus<\/jats:italic>\n                      non\u2010obese\n                      <jats:italic>versus<\/jats:italic>\n                      combined, 34%\n                      <jats:italic>versus<\/jats:italic>\n                      49%\n                      <jats:italic>versus<\/jats:italic>\n                      56%), and 81% for\n                      <jats:styled-content style=\"fixed-case\">AHI<\/jats:styled-content>\n                      &lt;5 (obese\n                      <jats:italic>versus<\/jats:italic>\n                      non\u2010obese\n                      <jats:italic>versus<\/jats:italic>\n                      combined, 61%\n                      <jats:italic>versus<\/jats:italic>\n                      87%\n                      <jats:italic>versus<\/jats:italic>\n                      84%). Meta\u2010regression analyses demonstrate that postoperative\n                      <jats:styled-content style=\"fixed-case\">AHI<\/jats:styled-content>\n                      was positively correlated with\n                      <jats:styled-content style=\"fixed-case\">AHI<\/jats:styled-content>\n                      and body mass index z score before surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Meta\u2010analysis of current literature shows T&amp;A offers prominent improvement in a variety of sleep parameters. Improvements in non\u2010obese children exceeded those for obese children. Postoperative residual\n                      <jats:styled-content style=\"fixed-case\">OSA<\/jats:styled-content>\n                      remained in roughly half of the children, especially those with severe disease and obesity, making additional treatment strategies and\/or long\u2010term follow\u2010up highly desirable.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.12549","type":"journal-article","created":{"date-parts":[[2015,10,5]],"date-time":"2015-10-05T11:14:44Z","timestamp":1444043684000},"page":"498-510","source":"Crossref","is-referenced-by-count":131,"title":["Polysomnographic findings after adenotonsillectomy for obstructive sleep apnoea in obese and non\u2010obese children: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"41","author":[{"given":"C.\u2010H.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Taipei Hospital Ministry of Health and Welfare New Taipei City Taiwan"},{"name":"Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.\u2010C.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Sleep Center National Taiwan University Hospital Taipei Taiwan"},{"name":"Department of Otolaryngology National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.\u2010H.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Taipei Hospital Ministry of Health and Welfare New Taipei City Taiwan"},{"name":"Department of Otolaryngology National Taiwan University Hospital Taipei Taiwan"},{"name":"College of Medicine Fu Jen Catholic University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.\u2010T.","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan"},{"name":"Sleep Center National Taiwan University Hospital Taipei Taiwan"},{"name":"Department of Internal Medicine Hsiao Chung\u2010Cheng Hospital New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.\u2010T.","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Taipei Hospital Ministry of Health and Welfare New Taipei City Taiwan"},{"name":"Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan"},{"name":"Department of Otolaryngology National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1671"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2007.091132"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0688"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2012.5"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078666"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.05.038"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.12.011"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2013.09.001"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2012.08.004"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811409837"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.12.018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.02.033"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.043"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.12.038"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.06.005"},{"key":"e_1_2_10_17_1","unstructured":"WellsG.A. 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